Surgical device



July 30, 1963 E. F. RIES 3,099,441

SURGICAL DEVICE Filed Dec. 29, 1959 2 Sheets-Sheet l 30 32. m. 49 47 48 Eg [[Illl llll IIHI] INVENTOR. ELMER' F. RIBS Auonpey July 30, 1963 E. F. RIES 3,099,441

SURGICAL DEVICE Filed Dec. 29, 1959 2 Sheets-Sheet 2 INVENTOR. EL MER E 78155 i i/ M United States Patent poration of Ohio Filed Dec. 29, 1959, Ser. No. 862,517 Claims. (Cl. 269328) This invention relates to improvements in a surgical device, particularly to a clamp mechanism for securing the head of a patient in adjustable fixed positions during an operation.

In the performance of neurosurgical operations it is necessary that the patien-ts head be fixed, or immovable, whether such movement would occur through the action of the patient himself or through pressure on the head by the surgeon, the anesthesiologist or other attendants. At the same time it is necessary that the said doctors have all of the room necessary for their work and a clear view of the patient While working or operating.

Various attempts have been made to provide the said head clamp but have failed in various particulars and which failures have been overcome by the head clamp of the present invention.

It is, therefore, the principal object of the present invention to provide a head clamp for use with operating chairs and tables for rigidly holding a patients head during an operation.

Another object of this invention is the provision of a head clamp for accomplishing the foregoing objects which is so designed that obstruction to the doctors while working and their view of the area in which they are Working is reduced to a minimum.

A further object of this invention is the provision of a head clamp which While accomplishing the foregoing objects is adapted for use in all positions of the patients head whether the patient is in a horizontal position, a supine position, prone position, unilateral position or upright position.

A further object of this invention is the provision in a head clamp, as disclosed in this invention, of a single operating member whereby the several clamping means are automatically adjusted and have equal clamping pressure.

A still further object of the present invention is the provision in head clamp for accomplishing the foregoing objects of means 'whereby the exact pressure being applied to the head in holding same is known and whereby a predetermined amount of pressure may be employed.

Other objects and advantages of the present invention should be readily apparent by reference to the following specification considered in conjunction with the accompanying drawings forming a part thereof and it is to be understood that any modifications may be made in the exact structural details there shown and described, within the scope of the appended claims, without departing from or exceeding the spirit of the invention.

In the drawings:

FIG. 1 is a perspective view showing the head clamp of the present invention in one position of use.

FIG. 2 is an enlarged, vertical, sectional view through the head :cla-mp as seen from line 2-2 on FIG. 1.

FIG. 3 is a transverse, vertical, sectional view through a portion of the clamp as seen from line 33 on BIG. 2.

FIG. 4 is a transverse, vertical, sectional view through the head clamp as seen in a plane to the left of FIG. 3

on line 4-4 on FIG. 2.

"ice

FIG. 7 is a view partly in elevation and partly in cross section illustrating a detail of the invention as seen from line 77 on FIG. 2.

'FIG. 8 is a perspective view of the clamp operating or actuating member and forming a detail of the invention.

Throughout the several views of the drawings similar reference characters are employed to denote the same or similar parts.

The clamp of the present invention while clamping or immovably fixing the head of a patient during an operation, in realty, actually secures the patients head by clamping or immovably fixing the skull of the patient and engages the relatively solid boney structure at the upper or top end of the skull, including the forehead and the back of the skull opposed to the forehead. In practice and basically the patients skull, indicated in the drawings by the reference numeral 10, is rigidly clamped between three needlelike points 11, 12 and 13 which penetrate the skin and tissue and are slightly embedded in the skull bone. It should be here noted that even under the maximum pressure exertable by the clamp that no permanent, or even temporary, for that matter, damage is caused to the patients skull, skin or tissue. The slight punctures in the patients skin and tissue rapidly close and heal after the removal of the clamp While the skull itself is barely penetrated by the said clamp points.

The clamp point 1 1 is carried by the upper end of a clamp arm 14 while the clamp points 12 and 13 are carried by the opposite ends of a crescent shaped rocker 15 in turn carried by clamp arm 16. The clamp arms 14 and 16 are respectively portions of relatively shiftable clamping mechanisms and respectively indicated in their entirety by the reference numerals 17 and 18.

The clamping mechanism 17 comprises a tubelike member 19 rectangular in cross section, preferably square, as shown in FIG. 4 having welded to its outer end the upstanding arm 14. The arm 14 is provided at its upper end with an integral sleeve 20 in which is removably mounted the clamp point, clamp member, per se. The clamp point, per se, comprises a collar 22 intermediate its ends and with a cone shaped portion '23 projecting from one side thereof and terminating in the needlelike clamping point 11. The collar 22 has projecting from its other side a cylindrical stud 24 provided substantially centrally of its length with a reduced diameter portion or channel 25 that cooperates with a spring loaded detent member or ball 26 retained in a socket 27. The construction and operation of the spring detent ball 26- is well known and is effected by peening the upper end of the socket 27 to prevent the ball escape after the said ball and its operating spring are placed in the socket. In order that the said socket may be formed in the arm '14 and its parts subsequently assembled therewith the arm sleeve 20 is provided with an aperture 28 directly opposite said socket 27.

The slid-ing member or tube -19 has secured to, preferably, within, its inner end a nut 29 for cooperation with a clamp screw and through which clamp screw and nut the said clamp mechanism 17, as a whole, is movable as will subsequently be made clear.

The tube 19 is adapted to telescope with a tube 30 forming a part of the clamping mechanism 18. The tube 30 is, therefore, rectangular in cross section, and preferably square, again as illustrated in FIG. 4. The tube 30, as noted above, has the tube 19 telescoped within one end thereof and has its other or outer end closed by an upstanding relatively short plate 31. The plate 31, in reality, has secured thereto, preferably by welding, the clamp arm 16 and which clamp arm is conveniently formed of two upstanding members 16a and 16b and with said arms 16a and 16b having their lower ends on the tube 30 and secured thereto, again, preferably by welding. The arms 16a and 16b are spaced from one another to provide a passageway 32 between them and in which passageway is disposed the rocker 15. In order to secure the parts to one another the upper ends of said clamp arm members 16a and 1611, as well as the portion of the rocker disposed therebetween, are provided with aligned perforations through which extends a pivot and clamp screw 33'. Further, for the purpose of securing the parts to one another, the clamp arm section 16b has its perforation internally threaded to have screwed thereinto the threads 34 of the thumb screw 33.

The rocker is provided at its opposite ends with sleeves, respectively, 35 and 36 similar in all respects to the sleeve 20 at the upper end of the clamp arm 14. Said sleeves are arranged with respect to the rocker and to one another in such a manner that their axes converge and intersect at a point intermediate the clamp arms 14 and 16. As noted above the said rocker has at its ends the needlelike clamping points 12 and 13 and which points in their construction are similar to the needle like point 11, in fact, said needlelike points are iinterchangeable with one another and are therefore alike in construction as above described in connection with the needlelike point 11. From the foregoing description and as clearly illustrated in FIG. 2 the clamping members, per se, or needle points 11, 112 and 13 each has its axes converging on one another and together form a three point clamp and that clamps with equal force as will presently be made clear.

As noted above the plate 31 is secured to and in efiect closes the outer end of the clamp mechanism member or tube 30 with said plate 31 having formed therethrough an aperture 37 which is axially aligned with the axis of said member or tube and through which aperture 37 projects a reduced diameter portion 38 of a clamp screw 39. The clamp screw 39 inwardly of the device has its threads in the nut 29 carried by clamp mechanism member or tube 19. The plate 31 outwardly thereof is provided with a sleeve 40 relative to which is telescoped a sleeve 41 projecting from a knob 42. The knob 42 is secured through a dog or clamp screw 43 to the outer end of the screw reduced portion 38.

The telescoping sleeves 40 and 41 between them house a coil spring 44 which abuts on one end with the plate 31 and on the other end with the knob 42. Normally the spring 444 is under suflicient tension to shift the clamp screw to the right, as seen in FIG. 2, and thereby maintain a shoulder 45 at the inner end of the screw reduced portion 38 against the inner surface of clamp plate 31.

The parts of the clamp thus far described and as illustrated in the drawings, particularly in FIGS. 1., 2 and 7, are in their normal positions, that is, with the clamping members, as exemplified by the needlelike points 11, 12 and 13, engaging the patients skull with substantially no clamping pressure between said clamp members and skull. Obviously this is effected through the rotation of the clamp screw 39 through its knob 42 which merely brings the clamping mechanisms 17 and 18 toward one another with the spring 44 holding the said clamp screw 39 against independent axial movement. Upon the said clamping members 11, 12 and 13- engaging the patients head and skull resistance is offered to the free movement of the clamping mechanisms 17 and 18 wherefore continued rotation of the screw 39 through its knob 42 will create a clamping pressure between the said clamping mechanism as the screw will then tend to axially move through the nut instead of causing the said nut to axially move on the screw. This clamping and movement of the parts is permitted since the spring 44 will now be compressed between the plate 31 and knob 42 with a reaction tending to yitehddably shift the clamping mechanisms toward one an- 0 er.

' and 60.

In practice use is made of a calibrated spring 44 and by suitable indicia ion the sleeve 41 the pressure being exerted by the clamp mechanisms readily determined. As clearly illustrated in FIGS. 7 and 8 the said knob knob sleeve 40 is provided with several lines 46, 47 and 48 and respectively carrying the markings 20, 40, These markings represent the pounds per square inch of pressure being exerted on the patients head and skull upon rotation of the clamping knob 42 when the said markings 46, 47 and 48 are aligned with the outer edge 49 of the sleeve 4i).

It is to be understood that the amount of clamping pressure desired will depend upon the operation being performed and on the position of the patient, that is, whether he is in a horizontal position, a supine position, prone position, unilateral position or upright po sition.

The clamp is adapted to be used as noted above in connection with an operating table or chair and is adjustably fixed with respect to the end thereof at which the patients head is to be disposed. The said head end of an operating chair is fragmentarily illustrated at 50 in FIG. 1, it being understood that a suitable supporting mechanism (not shown) is associated with said chair 50, and said chair 50 or its supporting mechanism is provided with a supporting frame such as 51 which is in itself adjustably positionable with respect to the chair, the mounting of said frame 51 being not shown in the drawings as it forms no part of the present invention.

As illustrated in FIG. 1 the supporting frame 51 in- .cludes a supporting bar 52 from which, at a point intermediate its ends, projects a universally adjustable ball and socket device 53 of a type illustrated in detail in FIG. 4 and to be described. The said ball and socket mechanism 53 is part of a clamp mechanism indicated in general by the reference numeral 54 and with said clamp mechanism 54 adapted to be secured in adjusted positions, insofar as its universal joint 53 is concerned, through a clamp screw 55.

The clamp mechanism 54 comprises a sleeve 56 longitudinally split at 57 with outwardly projecting cars 58 and 59 located respectively on each side of the said sleeve slit or split 57. Extending through said ears 58 and 59 is a clamp screw 60 whereby to clamp, in adjusted axial positions, an upstanding member 61, in reality a tube, passing through the bore of the sleeve 56. In order to connect the clamp mechanism 54 with the universal joint 53 the sleeve 56 has projecting from one side thereof a boss 62 through which the physical connection with the universal joint 53 is effected.

The upstanding member or tube 61 carries at its upper end the bead clamp above described with the connection between the said head clamp and tube 61 being effected in any suitable or desirable manner but preferably as illustrated in the drawings and including the following construction.

Secured to the upper end of said upright member or tube 61 is a universal joint indicated in its entirety by the reference numeral 63 and similar in all essential respects to the universal joint '53 between the clamp mechanism 54- and supporting bracket arm 52.

The universal joint 63 comprises a body member 64 welded or otherwise secured as at 65 to the upper end of the tube 61. The body member 64 is encircled and has secured thereto through screws or the like 66 a sleevelike housing 67. Disposed within the housing 67 is a ball 68 retained against displacement from the housing 67 by inwardly forming the upper end 69' of said housing and thereby providing an outlet from said housing of a diameter smaller than the diameter of the said ball 68. The housing 67', its reduced upper end 69 and the ball 68- are so related to one another that the ball may be readily rotated within the housing.

The body member 64 is provided in its inner end with a socket 70 supporting one end of a spring 71 which has its other end in abutment with the ball 68 and the parts are so proportioned to one another that the spring 71 yieldably holds the ball 68 against the reduced portion 69 of the housing 67 with such force that there is no play between the ball 68 and its housing 67, but, there is also no interference to the rotation or operation of the said ball with respect to the housing 67.

The ball is however securable against rotation by a clamping rod 72 which extends substantially centrally of the tube 61 and has its upper or inner end threaded as at 73 and threaded through an aperture 74 substantially centrally of the body member 64 and with the end of the clamping rod 72, more particularly, the end of the clampin-g rod threaded portion 73, in contact with the ball 68. It is believed obvious that rotation of the clamping rod 72 and its threaded portion 73 inwardly will through its abutting inner end clamp the ball 68 between itself and the inward projection or flange 69 of the housing 67.

The clamping rod 72 is rotatable through a knob 75 secured to the end thereof which projects beyond the lower outer end of the tube 61. It will be noted from FIG. 4 that the clamping rod 72 is of a much smaller diameter than the interior diameter of the tube 61 and in order to stabilize the rod 72 with respect to the tube 61, the tube 61 has welded to its lower outer end a washerlike plate 76 substantially centrally apertured to provide a stabilizing bearing for the outer end of the rod 72.

Secured to and projecting from the ball 68 is a pin or short shaft 77 having secured thereto, as by dowel 78, one member 79 of a union indicated in its entirety by the reference numeral 80. The union member 79' has at its one end a radial flange 81 in face contact with a second and externally threaded union member 82 secured by a dowel 83 to a short shaft or pin 84. A union nut 85 including an inwardly projecting radial flange 86 threadedly mounted on the said second union member 82 connects the union members 79 and 82 with one another. Stabilizing pins or keys 87 prevent relative rotation between the union members during the connection thereof one with the other by the nut 85.

The shaft or pin 84 connects with the union member 82, through a dowel 88, head or skull clamp securing member 89. The securing member 89 constitutes one half of a device known in the trade as a sunburst connection.

As is well known a sunburst connection includes a pair of substantially similar circular discs such as 89 and a companion disc '90 which are arranged in face to face contact with said faces respectively having interlocking or intermeshed clutchlike teeth 91. One of said plates, plate 89, herein, is substantially centrally apertured through which extends a thumb clamp screw 92 having its inner threaded end 93 received in a threaded aperture substantially centrally of the said second plate 90. The clamp screw 92 is provided on its outer end with a shouldered operating means 94 and to prevent disassociation of the clamp screw 92 and the sunburst connection securing member or plate 89 the said clamping screw is provided intermediate its ends with a reduced portion on which is mounted a split ring 95'.

It is through the said sunburst connection that the head and skull clamp is attached to the universal joint 63 and which sunburst connection has its second plate 90 permanently secured to the head or skull clamp, particularly, to the clamp mechanism 18, preferably, through its tubelike member 30.

The particular mechanism disclosed in the drawings for connecting the sunburst connection comprises a second connecting plate 96 similar in all respects to the plate 90 except that the said plate 96 faces in the opposite direction to the plate 90 with said plates being connected by a bridge 97 and through which bridge securing screws 98 pass in attaching the said plates 90-96 to the clamping mechanism member or tube 30. This connection is actu- 6 ally elfected through a clamping plate 99 welded to the lower face of the member or tube 30 and which construction is preferable due to the relative thinness of the wall of said member or tube 30.

The operation of the head or skull clamp of the present invention is believed obvious from the foregoing descrip tion but briefly is as follows:

The relative position of the head clamp with respect to the height of the operating chair or table 50 is effected by raising or lowering the upstanding member or tube 6 1 with respect to the clam-ping device 54 and the position of the said head clamp toward or from the said operating table or chair 50 may be eifected through the universal joint 53- which is readily clamped and uncl-amped through the clamping screw 55.

The position of the bead clamp at the upper end of the said upstanding member or tube 61 is readily positionable through an arc of 360 on the axis of the sunburst connection and particularly the axis of its clamping screw 92. The said head or skull clamp may be further adjustable in the same general direction or arc through the universal joint 63, this adjustment being effected through finer or smaller arcs than with the said sun- [burst connection since the said sunburst connection is adjustable only through the distance of its engaging clutch teeth. At the same time the said head or skull clamp may be further adjusted toward and from the operating chair or table through the said ball joint 63.

The adjustment of the head or skull clamp on or through the ball joint 63 is effected upon the loosening and subsequent retightening of the clamp rod 72 and wherefore adjustments in the angularity of these parts may be readily accomplished while an operation is in progress on a patient since it is only necessary to open and close one clamp part and which arrangement is readily accomplished through the single knob 75.

While the head or skull clamp is illustrated in FIG. 2 with the clamping needlelike points 11, 12 and 13 engaging the forehead and the back of the head it is readily understood that the clamp, or the patients head or skull, in effect, may be turned through an arc of 180 in each direction wherefore the single ueedleh'ke clamping point 11 may engage along either side of the patients head or skull to a point substantially diametrically opposed to that illustrated in said FIG. 2, and wherefore the cooperating clamping needlelike points 12 and 13 will occupy positions in opposition to said clamping needlelike point 11. It will further be noted that the head or skull clamp may depend from the sunburst connection as well as upstand therefrom as illustrated in the drawings.

In the operation of the head or skull clamp, per se, it will be obvious that, as intimated above, free movement of the clamping mechanisms .17 and 18 upon being stopped that any pressure applied by one of the clamping mechanisms will be equally applied by the other clamping mechanism through the coil spring 44. Itshould also be noted that the clamping needlelike points 12 and 13 are mounted on a freely oscillatable rocker and that any pressure exerted against one of said points 12 or 13 will be immediately transmitted to the other so that the pressure between all three points is at all times equal.

From the foregoing it will now be appreciated that there has been provided a surgical device which accomplishes the objects initially set forth.

What is claimed is:

1. In a surgical device the combination of a pair of clamping mechanisms each including an upstanding clamping arm in opposition to one another, a clamping point at the upper end of the first of said clamping arms, a pair of spaced clamping points carried by the upper end of the second of said clamping arms, means mounting said spaced clamping points on said second clamping arm for unitary oscillatory movement relative to said clamp ing arm, said clamping points each having its axis angu- 7 larly of the others and said clamping points bearing a relationship to one another to form between them a three point clamp, and means fior actuating the clamping mechanisms and their clamping points toward and from one another to effect a clamping by the clamping arms clamping points.

2. In a surgical device the combination of a pair of clamping mechanisms each including an upstanding clamping arm in opposition to one another, a clamping point at the upper end of the first of said clamping arms, a pair of spaced clamping points carried by the upper end of the second of said clamping arms, means mounting said spaced clamping points on said second clamping arm for unitary oscillatory. movement relative to said clamping arm, said clamping points each having its axis angularly of the others and said clamping points bearing a relationship to one another to form between them a three point clamp, means for actuating the clamping mechanisms and their clamping points toward and from one another to effect a clamping by the clamping arms clamping points, and yieldable means between said clamping mechanisms for yieldably and equally increasing the clamping pressure as exerted by the clamping mechanisms.

3. In a surgical device the combination of a pair of clamping mechanisms each including a body member telescoped with respect to one another, a clamping arm upstanding from an opposite end of said telescoping body members for movement toward and from one another as their body members are correspondingly moved, an actuating screw rotatably carried by one of said telescoping body members having a threaded connection with the other of said body members, said rotatable connection of the screw with the body member being such that independent axial movement may be had between them, yieldable means normally preventing said axial movement of the screw and its body member whereby rotation of the screw effects the telescoping movement of the clamp mechanisms body members, clamp means, per se, carried by each clamping arm, and means carried by the screw for efieoting its rotation and the actuation of the body members relative to one another to bring the clamping means, per se, into clamping positions and said screw actuating means effecting a compression in the yieldable means and establishing an equal clamping pressure by the clamping means per se.

4. In a surgical device the combination of a pair of clamping mechanisms each including a body member telescoped with respect to one another, a clamping arm upstanding from an opposite end of said telescoping body members for movement toward and from one another as their body members are correspondingly moved, an actuating screw rotatably carried by one of said telescoping body members having a threaded connection with the other of said body members, said rotatable connection of the screw with the body member being such that independent axial movement may be had between them, yieldable means normally preventing said axial movement of the screw and its body member whereby rotation of the screw efiects the telescoping movement of the clamp mechanisms body members, clamp means, per se, carried by each clamping arm, means carried by the screw for efiecting its rotation and the actuation of the body members relative to one another to bring the clamping means, per se, into clamping positions and said screw actuating means efiecting a compression in the yieldable means and establishing an equal clamping pressure by the clamping means per se, andmeans indicating the amount of compression in the yieldable means and the amount of clamping pressure being exerted by the clamping means per se.

5. In a surgical device the combination of a pair of clamping mechanisms each including a body member telescoped with respect to one another, a clamping arm upstanding from an opposite end of said telescoping body members for movement toward and from one another as their body members are correspondingly moved, an actuating screw rotatably carried by one of said telescoping body members having a threaded connection with the other of said body members, said rotatable connection of the screw with the body member being such that independent axial movement may be had between them, yieldable means normally preventing said axial move ment of the screw and its body member whereby rotation of the screw effects the telescoping movement of the clamp mechanisms body members, clamp means, per se, carried by each clamping arm, means carried by the screw for effecting its rotation and the actuation of the body members relative to one another to bring the clamping means, per se, into clamping positions and said screw actuating means effecting a compression in the yieldable means and establishing an equal clamping pressure by the clamping means per se, means indicating the amount of compression in the yieldable means and the amount of clamping pressure being exerted by the clamping means per se, and means mounting the clamp mechanisms for movement in all directions.

6. In a surgical device the combination of a pair of clamping mechanisms each including a body member telescoped with respect to one another, a clamping arm upstanding from an opposite end of said telescoping body members for movement toward and from one another as their body members are correspondingly moved, an ac tuating screw rotatably carried by one of said telescoping body members having a threaded connection with the other of said body members, said rotatable connection of the screw with the body member being such that independent axial movement may be had between them, yieldable means normally preventing said axial movement of the screw and its body member whereby rotation of the screw effects the telescoping movement of the clamp mechanisms body members, a clamping point associated with the first of said clamping mechanisms clamping arm, a pair of clamping points associated with the second of said clamping mechanisms clamping arm, said clamping points between them forming a three point clamp and moveable toward and from one another upon the telescopic movement of the clamp mechanisms body members, and means carried by the screw for eifecting its rotation and the telescopic movement of the body members relative to one another to bring the clamping points into clamping positions, and said screw actuating means effecting a compression in the yieldable means and establishing an equal clamping pressure on each of the said clamping points.

7. In a surgical device the combination of a pair of clamping mechanisms each including a body member telescoped with respect to one another, a clamping arm upstanding from an opposite end of said telescoping body members for movement toward and from one another as their body members are correspondingly moved, an actuating screw rotatably carried by one of said telescoping body members having a threaded connection with the other of said body members, said rotatable connection of the screw with the body member being such that independent axial movement may be had between them, yieldable means normally preventing said axial movement of the screw and its body member whereby rotation of the screw eifects the telescoping movement of the clamp mechanisms body members, a clamping point associated with the first of said clamping mechanisms clamping arm, a pair of clamping points associated with the second of said clamping mechanisms clamping arm, said clamping points between them forming a three point clamp and moveable toward and from one another upon the telescopic movement of the clamp mechanisms body members, means mounting said pair of clamping points of said second clamping mechanism clamping arm for unitary oscillation relative to its clamping mechanism and the clamping point of the first clamping mechanism clamping arm, and means carried by the screw for effecting its rotation and the telescopic movement of the body members relative to one another to bring the clamping points into clamping positions and said screw actuating means etfecting a compression in the yieldable means and establishing an equal clamping pressure on each of the said points.

8. In a surgical device the combination of a pair of clamping mechanisms each including a body member telescoped with respect to one another, a clamping arm upstanding from an opposite end of said telescoping body members for movement toward and from one another as their body members are correspondingly moved, an actuating screw rotatably carried by one of said telescoping body members having a threaded connection with the other of said body members, said rotatable connection of the screw with the body member being such that independent axial movement may be had between them, yieldable means normally preventing said axial movement of the screw and its body member whereby rotation of the screw effects the telescoping movement of the clamp mechanisms body members, a clamping point associated with the first of said clamping mechanisms clamping arm, a pair of clamping points associated with the second of said clamping mechanisms clamping arm, said clamping points between them forming a three point clamp and moveable toward and from one another upon the telescopic movement of the clamp mechanisms body members, means mounting said pair of clamping points of said second clamping mechanism clamping arm for unitary oscillation relative to its clamping mechanism and the clamping point of the first clamping mechanism clamping arm, means carried by the screw for effecting its rotation and the telescopic movement of the body members relative to one another to bring the clamping points into clamping positions and said screw actuating means eifecting a compression in the yieldable means and establishing an equal clamping pressure on each of the said clamping points, and means indicating the amount of compression in the yieldable means and the amount of said clamping pressure being exerted by the clamping points.

9. In a surgical device the combination of a pair of clamping mechanisms each including a body member telescoped with respect to one another, a clamping arm upstanding from an opposite end of said telescoping body members for movement toward and from one another as their body members are correspondingly moved, an actuating screw rotatably carried by one of said telescoping body members having a threaded connection with the other of said body members, said rotatable connection of the screw with the body member being such that independent axial movement may be had between them, yieldable means normally preventing said axial movement of the screw and its body member whereby rotation of the screw effects the telescoping movement of the clamp mechanisms body members, a clamping point associated with the first of said clamping mechanisms clamping arm, a pair of clamping points associated with the second of said clamping mechanisms clamping arm, said clamping points between them forming a three point clamp and moveable toward and from one another upon the telescopic movement of the clamp mechanisms body members, means mounting said pair of clamping points of said second clamping mechanism clamping arm for unitary oscillation relative to its clamping mechanism and the clamping point of the first clamping mechanism clamping arm, means carried by the screw for effecting its rotation and the telescopic movement of the body members relative to one another to bring the clamping points into clamping positions and said screw actuating means eifecting a compression in the yieldable means and establishing an equal clamping pressure on each of the said clamping points, means indicating the amount of compression in the yieldable means and the amount of clamping pressure being exerted by the said clamping points, and means mounting the clamp mechanisms for movement in all directions.

10. In a surgical device the combination of a pair of clamping mechanisms each including a body member telescoped with respect to one another, a clamping arm upstanding from an opposite end of said telescoping body members for movement toward and from one another as their body members are correspondingly moved, an actuating screw rotatably carried by one of said telescoping body members having a threaded connection with the other of said body members, said rotatable connection of the screw with the body member being such that independent axial movement may be had between them, yieldable means normally preventing said axial movement of the screw and its body member whereby rotation of the screw efiects the telescoping movement of the clamp mechanisms body members, clamp means, per se, carried by each clamping arm, means carried by the screw for effecting its rotation and the telescopic movement of the body members relative to one another to bring the clamping means, per se, into clamping positions and said screw actuating means eiiecting a compression in the yieldable means and establishing an equal clamping pressure by the clamping means, per se, means indicating the amount of compression in the yieldable means and the amount of clamping pressure being exerted by the clamping means per se, and means mounting the clamp mechanisms for movement in all directions including a ball carried by one of the clamp mechanisms body portion, a housing for said ball, yieldable means between the ball and housing for yieldably retaining the ball in position within the housing, and a clamp screw carried by the ball housing operable to rigidly clamp the ball within the ball housing.

References Cited in the file of this patent UNITED STATES PATENTS 1,625,682 Ragg Apr. 19, 1927 1,814,876 Weber July 14, 1931 2,494,792 Bloom Jan. 17, 1950 2,509,086 Eaton May 23, 1950 2,932,867 Douglass Apr. 19, 1960 2,966,383 Boetcker et al Dec. 27, 1960 FOREIGN PATENTS 910,078 France May 27, 1946 869,842 Germany Mar. 9, 1953 

1. IN A SURGICAL DEVICE THE COMBINATION OF A PAIR OF CLAMPING MECHANISMS EACH INCLUDING AN UPSTANDING CLAMPING ARM IN OPPOSITION TO ONE ANOTHER, A CLAMPING POINT AT THE UPPER END OF THE FIRST OF SAID CLAMPING ARMS, A PAIR OF SPACED CLAMPING POINTS CARRIED BY THE UPPER END OF THE SECOND OF SAID CLAMPING ARMS, MEANS MOUNTING SAID SPACED CLAMPING POINTS ON SAID SECOND CLAMPING ARM FOR UNITARY OSCILLATORY MOVEMENT RELATIVE TO SAID CLAMPING ARM, SAID CLAMPING POINTS EACH HAVING ITS AXIS ANGULARLY OF THE OTHERS AND SAID CLAMPING POINTS BEARING A RELATIONSHIP TO ONE ANOTHER TO FORM BETWEEN THEM A THREE POINT CLAMP, AND MEANS FOR ACTUATING THE CLAMPING MECH- 